Active NPI
Louise Bronaugh, PH.D.
- Clinical Psychologist
- Eugene, OR
National Provider Identifier
1417627134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3814
- Practice address
- 132 E Broadway Ste 332
Eugene, OR 97401-3155 - Phone
- (541) 633-9296
- NPI assigned
- Sep 14, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3814 | OR | Primary |
| School Psychologist | 103TS0200X | 105462 | OR |
Addresses
Primary practice location
132 E Broadway Ste 332
Eugene, OR 97401-3155
Mailing address
5355 Saratoga St
Eugene, OR 97405-4067
Phone (541) 633-9296
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3814 | OR | MD | Clinical Psychologist |
| 105462 | OR | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727136000000",
"number": "1417627134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5355 SARATOGA ST",
"city": "EUGENE",
"state": "OR",
"postal_code": "974054067",
"telephone_number": "541-633-9296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 E BROADWAY STE 332",
"city": "EUGENE",
"state": "OR",
"postal_code": "974013155",
"telephone_number": "541-633-9296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRONAUGH",
"first_name": "LOUISE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-14",
"last_updated": "2024-09-24",
"certification_date": "2024-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "3814",
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "OR",
"license": "105462",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.